Introduction
Dynamic lines and wrinkles are caused by contractions of the delicate underlying muscles every time we smile, laugh or frown. The more emotion we show the deeper these lines and wrinkles are likely to be. Over the years however, constant and even sustained contraction of these muscles, may lead to more permanent lines and creases developing. While we may have earned every one of our worry or laughter lines, the prospect of these permanent creases in the skin may not appeal to everyone. With the advent of an approved drug, dynamic lines can be dramatically softened. The procedure, which uses a purified toxin produced by the bacterium Clostridium botulinum (Botox), is also termed cosmetic denervation. Although the toxin is the same as the one that causes a serious form of food poisoning (Botulism), the amount used in cosmetic surgery is so minute that no systemic or general reaction is likely to be seen.
Botulinum toxin has been used very safely and successfully since 1982 by ophthalmologists to treat nervous twitching of the eyelid and lazy eye. In fact, each year thousands of patients receive Botox treatments for a variety of other conditions but over the last 10 years it has become quite a popular treatment for reversing the visible signs of ageing. Although celebrated in the media mainly as a line remover Botox has more recently been used successfully to combat the problem of excessive sweating of the underarms, palms and even soles.
When injected into a given area Botox, which is the trade name of Botulinum toxin type A, reversibly blocks the impulses from the nerves to the tiny facial muscles that are related to expression lines. By doing this, the muscles cannot contract and therefore tend to relax. When muscles relax, the overlying skin remains smooth and unwrinkled while the untreated facial muscles continue to contract in a normal fashion, allowing normal facial expression to be unaffected.